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Top 5 reasons we visit the pharmacist
In the fourth of our five-part series, homeopathic pharmacist Lee Kayne looks at the top five reasons why people visit a pharmacy in relation to homeopathic treatments.
Pharmacists are the most accessible of all healthcare professionals, seeing more patients than all the other professions put together and are available – with no appointment needed – to offer advice on all aspects of healthcare including homeopathy. Homeopathy is a holistic form of medicine where the patient’s symptoms, history, temperament, behaviour and emotional state are considered by the doctor. This involves a long consultation that can last for over an hour to ensure the correct medicine is prescribed, but over the counter (OTC) remedies are also available. Many local pharmacies will stock a range of around 30 homeopathic medicines, known as polychrests, all of which have a wide spectrum of activity and can be used to treat common conditions, based on the symptoms alone without the need to individualise carefully. The pharmacist will also be able to obtain other medicines upon request.
Some pharmacists and pharmacy technicians may have specialist training in homeopathy and others will have acquired their own knowledge and experience of homeopathy in practice and so are able to offer advice on a wide range of conditions. In this article, I will share the top 5 reasons that a member of the public might visit a pharmacist for homeopathy. In common with my colleagues who have previously submitted articles for this series, most of these reasons are symptom related. However, and perhaps unique to pharmacy, the number one reason people consult a pharmacist about homeopathy – or indeed any health related issue – is not for a medicine but for advice.
1. Advice and information
Pharmacists are experts on medicines, so it is not surprising that we have become the first point of contact for many people wanting information about homeopathy.
Is it safe?
The patient’s first concern is whether homeopathy is safe. There are two aspects to consider here; is the medicine itself safe (intrinsic toxicity) and is it safe to use homeopathy in the circumstances presented (extrinsic safety). Homeopathic medicines are very dilute, containing minute quantities of active principle, in some cases such small amounts that we cannot detect them with methods that we have available today. For this reason, adverse reactions and interactions between medicines do not occur as they do for many conventional medicines and herbal remedies. Occasionally, however, a medicine which is prescribed correctly will initially cause a slight worsening of the symptoms, which is known as an aggravation. This is not necessarily a bad thing, but should it occur, the medicine should be discontinued to allow the symptoms to return to the previous level and then restarted at a lower dose.
What can it treat?
The conditions that lend themselves to OTC treatment are mainly acute self-limiting conditions including coughs, colds, allergies, etc. Colic and teething in infants and sports injuries are other examples of situations where homeopathy is useful. Generally speaking, homeopathic medicines are not strong enough to eliminate invaders to the body and so cannot be used alone in the direct treatment of infections, although they are very useful in alleviating the symptoms and can be taken quite safely alongside conventional medication from your doctor. Homeopathy is also rarely effective where there is a physical deficiency of some kind in the body, e.g. vitamin, mineral or hormone; again this is because the medicines are given in such small quantities. Some serious, long-term conditions can benefit greatly from homeopathy, but these are not available OTC, and you must first seek a consultation with a homeopathically trained doctor. org).
Does it work?
This is a difficult question and one for which there is no answer brief enough to include here. Suffice to say that, despite what the sceptics would have you believe, there is considerable evidence that homeopathic medicines work. However, due to the individualised nature of homeopathy, it is not possible to conduct randomised controlled clinical trials (RCT) in the same way as for conventional medicines. In homeopathy, one size does not fit all and a number of different medicines depending on the individual symptoms of each patient may be offered. Thus a patient-orientated approach to assessing outcomes is required, which is not widely accepted by the scientific community.
How does it work?
The honest answer is that we really don’t know exactly how homeopathic medicines work. But this is not unique – there are many conventional medicines that have no established mechanism of action and there are even uncertainties about common medicines like paracetamol. All we can say is that the medicines assist the body in responding to symptoms to bring a person back to their own individual state of “wellness”.
How do I take homeopathic medicines?
Homeopathic medicines are available as liquid and solid (tablets and capsules) oral dosage forms and also as topical creams, ointments and gels for application to the skin. Dosage forms should not be touched (the active ingredient is on the outside of the dosage form) but shaken from the bottle into the cap and placed on or under the tongue without touching. Liquid dosage forms may be dispensed directly on to the tongue or into a small amount of water for drinking. Other considerations are as follows:
- Store medicines only in the original container, at room temperature and away from strong-smelling substances.
- Medicines should not be taken within 30 minutes of food, drink, tobacco, toothpaste, other medication etc. If taking more than one homeopathic medicine, allow 5 minutes between each.
- Medicines in solid forms should be sucked or chewed. Hold liquid medicines in the mouth for 15 seconds before swallowing.
- Medicines should not be used beyond the expiry date printed on the label and any spilled medicines should be discarded.
What potency and dosage should I use?
The 6c potency is the most readily available OTC potency and the dosages below refer to this strength, but for first aid and acute use the 30c potency can also be used and indeed is preferable if available.
For first aid treatments
In this context we are not talking about only injuries resulting from an accident, but the immediate treatment for conditions like shock, diarrhoea, flu, stage-fright, etc. Depending on the severity of the condition, administer the dose every fifteen to thirty minutes for a maximum of six doses.
For acute treatments
After the first aid dosage suggested above, treatment may continue three or four times a day for five to ten days. Sometimes, in less severe conditions, this dosage is used first and is then reduced on improvement. If symptoms show no signs of improvement within 48hrs or indeed begin to worsen, you should make an appointment to see your GP. If you are in any doubt, consult your pharmacist immediately.
For chronic treatments
Here the term “chronic” does not mean long-term medical conditions such as heart disease, asthma or depression, for conditions like these must be treated by your GP. However, non-acute conditions like a sprained ankle that has been troubling for a couple of weeks or longer; seasonal allergies; a bad back that gives a rheumatic “twinge” in wet weather; or a troublesome cough following a bout of flu are suitable for homeopathic treatment. Here a twice daily dose might be suggested with a review after four to six weeks. I cannot overstress that here I am not talking about long-term medical conditions such as emphysema or chronic heart disease.
Should I stop my other medicines while taking homeopathy?
Homeopathic medicines will not interfere with conventional medicines and I always advise that under no circumstances should anyone stop taking prescribed medicines without consulting their doctor first.
How do I know which homeopathic medicine to use?
For simple self-limiting conditions you can base your choice of medicine on two or three main symptoms known as “keynotes” e.g. mental and physical exertion and bruising (Arnica) or hot flushed appearance and sudden headache (Belladonna), seeking the advice of a pharmacist or using a reputable reference book as necessary to find the most appropriate medicine. This approach to acute prescribing is rather different to the more classical approach used by a homeopathic doctor who will want to know a lot more information about you and your condition before making a decision on how to treat you. Pharmacists will not prescribe for long-term conditions in an OTC situation unless they have undertaken advanced postgraduate training and, even then, will never treat a condition if they feel that homeopathy, the OTC pharmacy environment or indeed both are inappropriate. A pharmacist may feel that conventional medicine is a better option or that a GP should be consulted. If you asked for homeopathy and this is the answer you receive, please do not be disappointed or even angry – your safety and well-being is our primary concern. Sometimes the complementary approach of homeopathy plus conventional medicine works better than either one alone.
2. Colds and Flu
Colds and flu spread more easily during the winter as we tend to spend less time outdoors and turn the heating up indoors because of the cold weather. This, together with close contact with others in the home, at school, at work or on public transport creates a perfect environment for the spread of a virus. And the bad news is – there is no cure! The virus and its associated symptoms will not be defeated until the body produces antibodies against it and antibiotics usually have no effect, so we must concentrate on alleviating the symptoms.
Because homeopathy takes into account the overall symptom picture, two patients presenting with the same complaint might very well be given different homeopathic medicines. For example, in treating a fever, Belladonna might be recommended in cases of sudden onset, especially if a sore throat is one of the symptoms; whereas Ferrum Phos may be more appropriate if onset is gradual. In a patient who has a lot of catarrh which improves outside in the fresh air, Pulsatilla may be useful; but a patient who cannot get warm might be better with Nux Vomica. For the very first symptoms of a cold (sneeze number one) take Aconite and for more established symptoms like headache, shivers, aches and pains, Gelsemium is usually the medicine to take.
3. Mother & Baby
During pregnancy most prescription, OTC and even herbal remedies must be avoided as they can pose a risk to the developing baby, but homeopathic medicines are safe for both mother and baby and can be very effective in treating a wide range of pregnancy-related ailments. Nausea and vomiting is extremely common in early pregnancy and contrary to popular belief does not only occur in the morning! For nausea and retching but little vomiting use Nux Vom but for unremitting nausea and vomiting Ipecac might be better. For nausea specifically relieved by eating, Sepia might be the medicine to use. In labour, Arnica can be taken before and after to reduce the internal trauma.
From around 3-16 weeks of life, nearly all babies will exhibit some symptoms of colic and, while there is very little in conventional medicine to help, homeopathy has a few tricks up its sleeve! The most commonly employed medicine is Colocynth, especially for the baby that draws their legs up, likes to be carried and seems to gain some relief from firm pressure to the abdomen. For a baby who does not want to be picked up but has wind with diarrhoea, Chamomilla might be more suitable (this is also the medicine of choice for teething). Where there is a lot of wind but no other symptoms and the baby is generally happy, Carbo Veg might be best.
Sleep disturbances in babies and young children is another extremely common problem that can be the bane of many parents’ lives. Passiflora is a good medicine for babies who have no trouble getting to sleep but wake repeatedly during the night or wake too early in the morning, for no apparent reason.
Dosages for children are generally half that of adults. For babies, tablets can be crushed or an alternate dosage form such as soft tablets, powders, granules or crystals might be better. A pharmacist or pharmacy technician will be able to advise you on this.
4. Anxiety & Stress
Stress is triggered by different things in different people and symptoms vary. Physical symptoms may include headache, stomach upset, trembling, sweating and trouble sleeping; while emotional symptoms can include feelings of panic or anxiety, irritability, tearfulness and lack of concentration. Homeopathic medicines will not cause drowsiness or impair performance and are very useful for acute symptoms. But people suffering severe stress, panic attacks or whose symptoms continue for more than a few days should always seek treatment from a GP.
Aconite can be good for general symptoms of stress with no specific focus. Argent Nit is better for fear, anxiety or “nervous tummy”, specifically before an event, perhaps an exam, a performance, first day of school, or even a wedding! However, in cases where someone is paralysed with fear (stage-fright), use Gelsemium instead. Ignatia is the medicine of choice for people who are very emotional and often tearful, particularly following bereavement. And insomnia due to anticipation of an event will often respond well to Coffea.
5. Injuries, aches and pains
Trips, slips, sports injuries and simply overdoing it in the garden can lead to painful muscular injuries. Such injuries can often be treated homeopathically with Arnica as a tablet, cream or gel. However, there are a number of other options, especially where there is no obvious sign of bruising. Joint pain and soft tissue injuries respond well to Rhus Tox, particularly where the painful joint is stiff at rest but becomes more flexible on movement. Conversely, if the joint is worse with movement, Bryonia should be your choice. Strains and sprains, “pulled” muscles and “stretching” injuries of tendons and ligaments respond to Ruta Grav. Recently I have had great success treating sports injuries (some of which were my own) with RRA, a combination of Rhus Tox, Ruta and Arnica, taking the 30c potency three times a day while also applying Rhus Tox and Ruta Gel twice a day. The massage action of applying the gel assists in further reducing the discomfort associated with muscle injuries.
For cuts and abrasions the affected area should be cleaned with running water and perhaps an antiseptic wipe before applying a solution of five drops Calendula mother tincture in a small amount of water. For lacerations and crush injuries such as jamming fingers in a door or drawer, Hypericum is the homeopathic medicine to use. These two mother tinctures are often combined (Hyper-Cal) to make a very useful application for wounds and scars after dilution in water. It can also be mixed with warm water in a slightly stronger solution (ten drops to 100ml) and used as a mouthwash or gargle, especially useful after dental surgery (for more on homeopathic dentistry see Health and Homeopathy January 2010).
Finding a homeopathic pharmacist
Nearly all pharmacies will stock a limited range of homeopathic medicines and most pharmacists will have a basic understanding of homeopathic theory and practice via undergraduate or postgraduate teaching or from one of the books on homeopathy published by the Pharmaceutical Press.
There are also a number of pharmacists who have received specialist postgraduate training in a course accredited by The Faculty of Homeopathy. Successful completion of introductory training enables pharmacists and pharmacy technicians to become Licensed Associates of the Faculty of Homeopathy and use the qualification LFHom(Pharm). Pharmacists who go on to complete more advanced training achieve the qualifications DFHom(Pharm) and MFHom(Pharm), the highest level of training. To find a homeopathic pharmacist with Faculty qualifications, visit the British homeopathic Association’s website at www.britishhomeopathic.org. All members of the Faculty of Homeopathy are bound to practice within the competence of their profession and their level of training and qualification in homeopathy.
Lee Kayne PhD, MRPharmS, FFHom is Pharmacy Dean of the Faculty of Homeopathy and also Chief Pharmacist at Freeman’s Homeopathic Pharmacy in Glasgow